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2 0 u Environmental Health Department <br /> SAN 1 <br /> lltin �a C a U N T Y <br /> Greotness grows here <br /> Corrective Action Statement <br /> RE: April 29, 2021, Hazardous Materials inspection report <br /> For each violation listed below, indicate if the violation has been corrected or will be corrected by a certain date. Also, <br /> describe what was done to correct the violation in the space provided below each violation. Submit this completed form <br /> with the Return to Compliance Certification within 30 days of inspection. If you have any questions, please contact <br /> Haza Saeed at(209)953-6212 or hsaeed@sjgov.org. <br /> Facility name: Delta Water Supply Project Submit completed form to: <br /> Facility address: 11373 N LOWER SACRAMENTO RD SJC ENVIRONMENTAL HEALTH DEPARTMENT <br /> CERS ID: 10423735 ATTN: HAZA SAEED <br /> PR0539212 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Violation#4-Failed to electronically submit the Business Activities or OwnerlOperator Identification page. <br /> 0, This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: <br /> c \ti a At Q S c,u,,� ,�.e_ (� ,J nx ✓ rctiAc'-r -r �c P 1� b e-1- <br /> Violation#5-Failed to electronically submit hazardous materials inventory for all reportable materials on <br /> site. <br /> jff` This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: Cu <br /> CC;.�_,c..e.vlArc Jco,tiS. <br /> Violation#6-Failed to electronically submit a site map with all required content. <br /> l_ This violation was corrected ❑This violation will be corrected by(date): <br /> ❑ Supporting documents included <br /> Describe actions taken or will be taken to correct violation: G <br /> 1—r <br /> Lf 47 JCL 3 ('� v�� 7 �C eIrtG 1f <br /> Page 2 of 4 <br /> Rev 9/16202O <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-342C i F 209 464-0138 1 www.sjgov.org/EHD <br />